不同频率重复经颅磁刺激治疗恢复期脑梗死患者疗效观察

Effect of different frequency repetitive transcranial magnetic stimulation in treatment of convalescence cerebral infarction

目的探讨不同频率重复经颅磁刺激(r TMS)治疗脑梗死(CI)恢复期患者的临床效果。方法选择2009年12月至2011年1月在川北医学院附属医院接受重复r TMS治疗的CI恢复期患者96例,按治疗方法分为高频组(高频r TMS)、低频组(低频r TMS)和假刺激组,每组32例,对3组患者治疗前后的运动功能Fugl-Meyer评定量表(FMA)评分、Barthel指数(BI)、中枢运动传导时间(CMCT)及运动诱发电位(MEP)潜伏期进行比较。结果治疗前3组患者FMA评分、BI、MEP潜伏期及CMCT比较差异均无统计学意义(P>0.05)。治疗后3组患者的FMA评分、BI显著高于治疗前(P<0.05),而MEP潜伏期及CMCT显著短于治疗前(P<0.05)。治疗后高频组和低频组患者的FMA评分及BI显著高于假刺激组(P<0.05),治疗后高频组和低频组患者的MEP潜伏期和CMCT均显著短于假刺激组(P<0.05)。治疗后高频组和低频组患者FMA评分、BI、MEP潜伏期及CMCT比较差异均无统计学意义(P>0.05)。结论高、低频r TMS均可以显著促进CI患者运动功能恢复,且二者效果相当。

Objective To investigate the different frequency repetitive transcranial magnetic stimulation（ r TMS） in treatment of convalescence cerebral infarction（ CI）. Methods Ninety-six patients with convalescence CI at recovery stage were selected in the Affiliated Hospital of North Sichuan Medical College from December 2009 to January 2011. The patients were divided into high frequency group（ high frequency r TMS）,low frequency group（ low frequency r TMS） and sham stimulation group,thirty-two patients in each group. The Fugl-Meyer assessment（ FMA） score of motor function,Barthel index（ BI）,central motor conduction time（ CMCT） and motor evoked potential（ MEP） latency were compared among the three groups before and after treatment. Results There was no significant difference in FMA score,BI,MEP latency and CMCT among the three groups before treatment（ P〈0. 05）. The FMA score and BI after treatment were significantly higher than those before treatment（ P〈0. 05）,and the MEP latency and CMCT after treatment were significantly shorter than those before treatment in the three groups（ P〈0. 05）. The FMA score and BI in the high frequency group and low frequency group were significantly higher than those in the sham stimulation group after treatment（ P〉0. 05）. The MEP latency and CMCT in the high frequency group and low frequency group were significantly shorter than those in the sham stimulation group after treatment（ P〈0. 05）.There was no significant difference in FMA score,BI,MEP latency and CMCT between the high frequency group and low frequency group after treatment（ P〉0. 05）. Conclusion High and low frequency r TMS can significantly promote the recovery of motor function in patients with CI,and the effect is equivalent.